The inspiration to give back to the society guided the foundation to ponder on the status of health in the country and the way forward for future healthy generations. As a team we realized diseases are being ignored or unattended for various reasons – inability of the child to express, lack of awareness about sicknesses among communities, economic factors and others such.
While analyzing the main reasons the following have been found to impact the health of the future generations:
The health needs of communities have been changing as the times advance with the drastic alterations of human lifestyle across the globe both in its temporal and spatial characteristics.
The value system, the cultural moorings, the familial and societal bearings and most importantly the materialistic ambitions and aspirations of every society in the world have transformed so enormously that their consequential impact on health and well-being is baffling.
The rate of these changes has become exponential in recent times and we cannot blame the changing trends of the society because, change is inevitable and integral to the progression of human civilization.
These changes have now resulted in India facing a dual burden of disease. Communicable diseases still account for a significant proportion of the disease burden alongside non-communicable diseases (NCDs), such as cancer and cardio-vascular ailments. Communicable diseases account for 33% while NCDs 55% towards Disability Adjusted Life Years(DALYs).
President of India recently warned that the country is facing a possible mental health epidemic and there is a shortage of mental health professionals. There are just about 5000 psychiatrists and less than 2000 clinical psychologists in the country while 10% of Indians have one or the other mental health problem, 20% of people have substance abuse problem such as tobacco, alcohol, drugs etc., The biggest obstacle that patients of mental and neurological problems face is social stigma and denial. We need to talk about mental health issues and treat ailments such as depression and stress as diseases that can be cured – not as guilty secrets to be pushed under the carpet.
India has one of the highest rates of suicides in the world which is almost 1% of the population in India. According to some estimates, 1 in 3 persons, at some stage in their life, suffer from mental illness. According to National Alliance on mental illness, “A mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning”.
The National Mental Health Survey 2016 shows almost 150 million Indians need active mental health interventions including 9.8 million young Indians aged between 13-17 Years.
Three major issues are involved when we assess healthcare: access, quality and cost.
Indian Health Care - a 60 billion dollars industry, today is unable to balance public needs with commercial aspirations as a result the access, quality and affordability of health care is becoming a dream. Medical inflation in India is on average around 15%. Hospital costs are increasing. If the hospital room rent is INR 4000 today it rises to INR 4500 or more in six months later. Everything else is connected to that – from doctor’s fees to tests.
WHO and World Bank Report on out-of-pocket health expenditures show that more than 50 million people in India are thrown into poverty due to these expenses which average 62%of health expenditure and it accounts for 4.6% of poverty incidence in our country. Hospitalization costs have increased by 200% in the last 10 years.
In the absence of Government’s gap in providing quality care, private hospitals have stepped up to fill the gap of public health system. Industry remains highly capacity constrained with just 7 beds per 10,000 populations where the global median is 27 beds. Lack of quality doctors and insurance has made pricing truly a matter of life and death.
In India today, there is one doctor for 1700 people, compared to who norm of 1:1000. Most of these doctors are in urban regions, while close to 70% of Indians live in rural provinces. This gap will not close anytime soon. A 2015 Parliamentary Standing Committee report mentioned that even if India were to add 100 Medical Colleges per year for five Years, it would take till 2029 to achieve the WHO prescribed ratio.
India is short of 3469 community health centers for every 1,00,000 people, 5887 primary health centers for every 30000 people, 27430 sub-centers for every 5000 people. Around 38 million Indians rely on health facilities without electricity. The Rural Health Statistics 2016 data finds that India has around 25000 PHCs, and of the functional PHCs, 4.6% are not electrified.
It is private sector that delivers more than 80% of the health care services in the country. On the other hand, the decay in government hospitals is a reminder that public health spending at 1.5% of GDP is way below the global norm of over 6%. Here again the Health expenditure constitutes 93% while Capital expenditure is 7%. To make health care affordable a greater government role is important, and it goes with setting up hospitals and colleges, alongside better governance.
India’s population is expected to reach 1.7 Billion in the next 30 Years. Ensuring that all people have access to health services which are affordable, of good quality and within reach, is a public health imperative.
The members of the foundation observing the alarming status on healthcare in India established Choice Foundation to contribute their best to the country’s future generation’s health through the following Programs:
CHOICE Foundation is focused on Preventive, Protective and Curative Objectives through: